【摘要】：目的： 探討磁敏感加權圖像在檢出腦微出血與病理的關系。探討ESWAN的R2STAR值與腦發(fā)生微出血的相關關系。明確MRI-ESWAN掃描皮層及基底節(jié)的R2STAR值的驟然升高是否可以提前1-2周預示腦微出血。 材料與方法： 獲得卒中易感性自發(fā)性高血壓（SHR）高齡雄性鼠模型30只，按照實驗計劃連續(xù)監(jiān)測血壓及定期核磁共振掃描。使用血壓儀監(jiān)測時記錄每只SHR鼠的收縮壓（SBP）及舒張壓（DBP）。使用動物線圈掃描，MRI掃描序列包括ESWAN、3D-FRSG及T2-WI，測量ESWAN中的R2STAR值，并且觀察相位圖和/或大鼠腦內(nèi)是否出現(xiàn)微出血灶，記錄微出血灶的時間及部位。ESWAN序列相位圖和/或幅值圖腦內(nèi)任何部位微出血或出血灶為陽性組，未發(fā)現(xiàn)微出血或出血灶為陰性組。ESWAN發(fā)現(xiàn)腦出血后處死大鼠，進行腦組織病理切片觀察并與MRI圖像對比分析。未出血組在實驗終點處死。采用重復測量方差分析比較出血前多個不同時間、不同部位的R2STAR值。 結果： 卒中易感性自發(fā)性高血壓（SHR）高齡雄性鼠模型17只出現(xiàn)自發(fā)性腦出血，9只未出血，4只在實驗中死亡。陽性組與陰性組的血壓之間無統(tǒng)計學意義（P0.05）。陽性組出血前1-2W大腦皮層、基底節(jié)區(qū)R2STAR值病變側(cè)中心區(qū)高于陰性組末次，有統(tǒng)計學差異（P0.05)。38-68W陽性組病變側(cè)中心區(qū)及對側(cè)鏡相區(qū)R2STAR值均平穩(wěn)上升，68-74W陽性組病變側(cè)中心區(qū)R2STAR值上升較快（P0.05)，對側(cè)鏡相區(qū)變化相對平緩。陽性組出血前1-2W大腦皮層、基底節(jié)區(qū)R2STAR值病變側(cè)中心區(qū)明顯高于對側(cè)鏡相區(qū)，，有統(tǒng)計學差異（P0.05)。后處理ESWAN圖像中微出血灶或出血灶分布與病理切片觀察分布基本一致。ESWAN的R2STAR值升高的部位與隨后出現(xiàn)腦微出血的部位基本一致。 結論： 磁敏感加權圖像能夠檢測出腦微出血灶，基本準確的反映微血管病變的病理改變；皮層及基底節(jié)的R2STAR值升高的部位相繼發(fā)生微出血，且出血的位置與病理基本一致。采用ESWAN掃描，測量R2STAR值的變化可能預示高血壓自發(fā)性腦內(nèi)出血；
[Abstract]:Objective: to study the relationship between magnetic sensitivity weighted image and pathology in detecting cerebral microhemorrhage. To investigate the correlation between R2STAR value of ESWAN and cerebral microhemorrhage. To determine whether the sudden increase of R2STAR in cortical and basal ganglia on MRI-ESWAN scan can predict cerebral microhemorrhage 1-2 weeks ahead of time. Materials and methods: thirty aged male (SHR) rats with stroke susceptibility to spontaneous hypertension were obtained and their blood pressure was continuously monitored and MRI scans were performed regularly according to the experimental plan. Systolic blood pressure (SBP) and diastolic blood pressure (DBP).) were recorded in each SHR rat using a blood pressure monitor Using animal coil scanning and MRI scanning sequences including ESWAN,3D-FRSG and T2-WI, the R2STAR values in ESWAN were measured, and the phase map and / or microbleeds were observed in the brain. The time and location of microhemorrhage were recorded. ESWAN sequence phase map and / or amplitude map showed that microhemorrhage or haemorrhage was positive in any part of the brain, but no microhemorrhage or haemorrhage was found in negative group. The rats were killed after ESWAN found intracerebral hemorrhage. The pathological sections of brain tissue were observed and compared with MRI images. No bleeding group was killed at the end of the experiment. Repeated measurement variance analysis was used to compare the R2STAR values of different parts at different time before bleeding. Results: there were 17 cases of spontaneous cerebral hemorrhage, 9 cases of no hemorrhage and 4 cases of death in the male model of stroke susceptible spontaneous hypertension (SHR). There was no significant difference in blood pressure between positive group and negative group (P0.05). The R2STAR values of cortex and basal ganglia in the positive group were higher than those in the negative group (P0.05). The R2STAR values of the lesion side and the contralateral area in the 38-68W positive group were increased steadily. In the 68-74W positive group, the R2STAR value in the central region of the lesion increased rapidly (P0.05), and the change of the contralateral mirror phase was relatively gentle. In the positive group, the R2STAR values of cerebral cortex and basal ganglia were significantly higher than those of the contralateral area before hemorrhage (P0.05). The distribution of microhaemorrhage or haemorrhage in post-processing ESWAN images was basically the same as that observed by pathological sections, and the location where the R2STAR value of ESWAN increased was basically the same as that of subsequent intracerebral microhaemorrhage. Conclusion: magnetic sensitive weighted images can detect cerebral microhaemorrhage and reflect the pathological changes of microvascular lesions. Microhemorrhage occurred in cortex and basal ganglia where R2STAR value increased, and the location of hemorrhage was basically consistent with pathology. Using ESWAN scan, the change of R2STAR value may predict spontaneous intracerebral hemorrhage in hypertension.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743.34;R445.2

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